Kaiser HMO vs Anthem BCBS HSA?

Hi Reddit!

I’m trying to decide between two healthcare plans offered through my employer, and I’d love to get your opinions on which one might be better for me. Below are the details of each plan along with my current situation.

My Situation:

• Age: 23
• Location: California
• Health Status: Generally healthy with no major issues
• I take a generic thyroid medication every day
• I tore my shoulder labrum about a year ago, but there’s no pain, and surgery was offered as an option at the time, though it’s a very low chance I’d go for it.
• Current Plan: I’ve been with Kaiser for the last 2 years and have a primary care doctor that I like.
• Employer HSA Contribution: None
• Biweekly Premiums: Anthem HSA: $67.92 | Kaiser HMO: $73.02

Plan Options:

Anthem HSA Plan:

• Annual Deductible:
• In-network: $3250
• Out-of-network: $6500
• Out-of-pocket maximum:
• In-network: $5500
• Out-of-network: $11000
• Coinsurance:
• In-network: 20%
• Out-of-network: 50%
• Eligible preventive care services:
• In-network: $0
• Out-of-network: 50%
• Office visits:
• In-network: 20% after deductible
• Out-of-network: 50% after deductible
• Prescription drugs:
• Full cost until deductible is reached, then $12 for generic
• Specialty drugs (30-day supply):
• Full cost until deductible is reached, then $50 for generic

Kaiser HMO:

• Annual Deductible: $500 (in-network only)
• Out-of-pocket maximum: $3000 (in-network only)
• Coinsurance: 20%
• Eligible preventive care services: $0 (in-network)
• Office visits:
• Virtual: 20% after deductible
• Primary Care: $30
• Specialist: $50
• Urgent Care: $30
• Emergency Room: 20% after deductible
• Prescription drugs: Full cost until deductible is reached, then $10 for generic
• Specialty drugs (30-day supply): $75

What I’m Looking For:

• Staying healthy: I don’t expect many medical visits beyond the occasional checkup and my regular thyroid medication.
• Costs: I’m primarily concerned about monthly expenses for the medication and any unforeseen medical issues.
• Doctor preference: I’ve liked my Kaiser doctor, but I’m open to switching if the other plan makes more sense financially.
• Potential Surgery: While it’s unlikely I’ll need shoulder surgery, it’s still something to consider.

Given my situation, which plan do you think would be better for me? Is it worth switching from Kaiser to Anthem, or should I stick with Kaiser? Any advice or experience would be appreciated!